Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort
Authors: Per-Henrik Zahl, Karsten Juhl Jørgensen
Journal: Annals of Internal Medicine (2022)

LettersOctober 2022Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening CohortPer-Henrik Zahl, DrMedSci, MD, MSc and Karsten Juhl Jørgensen, DMedSciPer-Henrik Zahl, DrMedSci, MD, MScNorwegian Institute of Public Health, Oslo, NorwaySearch for more papers by this author and Karsten Juhl Jørgensen, DMedSciCochrane Denmark, Copenhagen, DenmarkSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L22-0275 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR: Ryser and colleagues (1) use a lead-time model to predict that 1 in 7 cases of screen-detected breast cancer will be overdiagnosed in a contemporary U.S. setting. They contend that the alternative excess-incidence model depends on a reliable estimate of breast cancer incidence in the absence of screening. This is correct, but the authors do not consider that variation in the time of introduction of breast screening in the Nordic countries has provided exactly that (2). This allows for a study design as close to a randomized trial as possible. Estimates of overdiagnosis provided by excess-incidence models ...References1. Ryser MD, Lange J, Inoue LYT, et al. Estimation of breast cancer overdiagnosis in a U.S. breast screening cohort. Ann Intern Med. 2022;175:471-78. [PMID: 35226520] doi:10.7326/M21-3577 LinkGoogle Scholar2. Jørgensen KJ, Gøtzsche PC, Kalager M, et al. Breast cancer screening in Denmark: a cohort study of tumor size and overdiagnosis. Ann Intern Med. 2017;166:313-23. [PMID: 28114661] doi:10.7326/M16-0270 LinkGoogle Scholar3. Independent UK Panel on Breast Cancer Screening. The benefits and harms of breast cancer screening: an independent review. Lancet. 2012;380:1778-86. [PMID: 23117178] doi:10.1016/S0140-6736(12)61611-0 CrossrefMedlineGoogle Scholar4. Davidov O, Zelen M. Overdiagnosis in early detection programs. Biostatistics. 2004;5:603-13. [PMID: 15475422] CrossrefMedlineGoogle Scholar5. Zahl PH, Jørgensen KJ, Gøtzsche PC. Overestimated lead times in cancer screening has led to substantial underestimation of overdiagnosis. Br J Cancer. 2013;109:2014-9. [PMID: 23963144] doi:10.1038/bjc.2013.427 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Per-Henrik Zahl, DrMedSci, MD, MSc; Karsten Juhl Jørgensen, DMedSciAffiliations: Norwegian Institute of Public Health, Oslo, NorwayCochrane Denmark, Copenhagen, DenmarkDisclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L22-0275. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEstimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Marc D. Ryser , Jane Lange , Lurdes Y.T. Inoue , Ellen S. O’Meara , Charlotte Gard , Diana L. Miglioretti , Jean-Luc Bulliard , Andrew F. Brouwer , E. Shelley Hwang , and Ruth B. Etzioni Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Sherwin Chiu , Benjamin Williams , Kevin Shahbazian , Michelle V. Lee Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Marc D. Ryser and Ruth B. Etzioni Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Arn Migowski Estimation of Breast Cancer Overdiagnosis in a U.S. Breast Screening Cohort Charles Harding , Dmitriy Burmistrov , Marybeth Pompei , Francesco Pompei Metrics October 2022Volume 175, Issue 10Page: W114-W115KeywordsBreast cancerBreast cancer screeningCancer epidemiologyCancer screeningMammographyNatural history of diseaseOverdiagnosisPrevention, policy, and public health ePublished: 18 October 2022 Issue Published: October 2022 Copyright & PermissionsCopyright © 2022 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...